The CEO of OhioHealth Corp., during an interview for his profile as Columbus Business First’s 2012 Businessperson of the Year, is describing the challenges that even a health-care business can face trying to bring down the cost of medical treatment for its employees. “The system is so broken,” he asserts, and gives this example from a few years ago:

Blom was talking with an OhioHealth nurse who was so worried about her weight that she was considering a gastric bypass, a drastic surgery to shrink the stomach volume and re-route digestion to skip a significant portion of the small intestine where nutrients are absorbed.

The nurse told Blom that to qualify for the operation under OhioHealth’s insurance plan, she needed to gain 7 pounds.

“I said are you kidding me?” he says. “I thought to myself, how screwed up is this?”

If health care is truly to be reformed, the companies that pay for health insurance must design better benefits plans that pay for the outcomes they want, Blom and others argue.

OhioHealth in recent years has moved all of its work force onto a high-deductible insurance plan and includes disease management and wellness programs, asking employees to take a more active role in managing their health and shopping carefully for medical care.

In 2011 it expanded Health4, a partnership between they system, the 2,000-doctor physician-owned Medical Group of Ohio, and several insurers serving Central Ohio. The plan pays bonuses to doctors who keep members healthy, keep up with all the needed protocols to manage a chronic disease like diabetes or asthma, and complete recommended preventative screenings such as mammograms.

The system’s workers have fewer hospitalizations and emergency room visits and an all-time low number of them are taking drugs to control blood pressure.

“Our health (spending) has dropped by 18 percent since 2007,” Blom says. “Not only do employees feel accountable for their health care, the doctors have financial incentives to keep our employees healthy.”

Instead of requiring members to gain dangerous amounts of weight before they get help for obesity, OhioHealth’s plan pays for consultations with a dietitian and other preventative steps such as on-site Weight Watchers.

“We now have the resources in place to help our employees manage their weight,” he says.